Which type of tympanoplasty involves reconstruction of the ossicular chain using an intact stapes with malleus handle present, along with tympanic membrane repair (Type IIIa as per Austin-Kartush modification)?

• A Myringoplasty only — graft over existing ossicles
• B Total ossicular replacement prosthesis (TORP) connecting graft to stapes footplate
• C Incus interposition graft placed between malleus handle and stapes head
• D Partial ossicular replacement prosthesis (PORP) connecting graft to stapes head ✓

Explanation

When the malleus handle is present and the stapes superstructure is intact but the incus is absent or eroded, a PORP (partial ossicular replacement prosthesis) bridges from the tympanic membrane/graft to the stapes head. A TORP is used when only the stapes footplate remains. Incus interposition is a biological alternative using the patient's own incus, but in the classic Wullstein classification Type III, the new drum rests directly on the stapes — the Austin-Kartush system provides more granular sub-classification based on residual ossicular anatomy.

Reference: Dhingra Diseases of Ear, Nose and Throat, 7th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.